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Audette v. Carrillo

United States District Court, D. Massachusetts

January 4, 2019

LLOYD F. AUDETTE, Plaintiff,



         This case concerns the quality of the medical care that Plaintiff Lloyd Audette received while incarcerated at the Massachusetts correctional institutions in West Concord and Shirley (“MCI Concord” and “MCI Shirley, ” respectively). Plaintiff claims that Defendants were deliberately indifferent to his serious medical needs, that when he complained of mistreatment, medical treatment was withheld, and that the care he eventually received was negligently provided. Before the Court are two motions for summary judgment-one filed by Defendant Adriana Carrillo, M.D., [ECF No. 167], and the other filed by Defendant Maria Angeles, M.D., [ECF No. 173]. For the reasons explained below, Dr. Angeles's motion is GRANTED, and Dr. Carrillo's motion is GRANTED in part and DENIED in part.


         Plaintiff's First Amended Complaint [ECF No. 16] asserted claims against eleven defendants, including (1) claims under 42 U.S.C. § 1983 for violation of rights guaranteed by the First, Eighth, and Fourteenth Amendments to the United States Constitution, and conspiracy to violate those rights through deliberate indifference as against Dr. Carrillo, Dr. Angeles, and others (Count I) and retaliation as against all Defendants (Count II), (2) violations of the Massachusetts Declaration of Rights and civil conspiracy as against Dr. Carrillo, Dr. Angeles, and others (Count III), (3) negligence as against Dr. Angeles and UMass Correctional Health (Count IV); and (4) negligence as against Dr. Carrillo and others (Count V), and (5) negligent infliction of emotional distress as against Dr. Carrillo and others (Count VI).

         Dr. Carrillo and Dr. DiCecca answered the Complaint [ECF Nos. 24, 37], while the remaining Defendants, including Dr. Angeles, moved to dismiss. [ECF Nos. 42, 55, 57, 62]. Two defendants had all claims against them dismissed by the Court [ECF No. 72], [1] and five additional defendants were dismissed by stipulation.[2]

         The Court dismissed Plaintiff's negligence and conspiracy claims against Dr. Angeles, but denied her motion to dismiss the non-conspiracy portions of Counts I, II, and III, leaving the claims for violations of federal and state constitutional rights pending against Dr. Angeles. [ECF No. 72 at 16]. Counts I, II, III, V, and VI-violations of constitutional rights, negligence, and negligent infliction of emotional distress-remain pending against both Dr. Carrillo and Dr. DiCecca. Dr. DiCecca has not filed a motion for summary judgment.


         As required by the applicable legal standard on a motion for summary judgment, the following factual summary draws all reasonable inferences in favor of Plaintiff as the non-movant.

         After being convicted of armed robbery in October 2009, Plaintiff began a period of incarceration at MCI facilities that lasted until May 2017. [ECF No. 181 ¶ 22]. Plaintiff contends that when he arrived at MCI Shirley in 2009, Dr. Angeles, who supervised Plaintiff's medical care there, told him “you will not receive any medical treatment because you like to file grievances.” [ECF No. 184 ¶¶ 3, 6]. Plaintiff suffered from a degenerative joint disease and had received oxycodone for pain management during a prior period of incarceration, but Dr. Angeles discontinued that prescription. [ECF No. 184 ¶¶ 9-10]. Dr. Angeles provided Plaintiff with limited treatment in 2010 and 2011 but neglected to provide pain medication stronger than over-the-counter, nonsteroidal anti-inflammatory agents and refused to see Plaintiff for several weeks in September 2010. [ECF No. 181 ¶¶ 5, 7; ECF No. 183-2 at 47:3-10]. In October 2011, a nurse practitioner at MCI Shirley recommended that Plaintiff receive a total left knee replacement [ECF No. 181 ¶ 8].

         The Department of Correction contracts third parties to provide health services to inmates, and Lemuel Shattuck Hospital (“Shattuck”) is the primary referral hospital for patients in need of off-site surgeries. [ECF No. 179-6 at 137-138]. Shattuck in turn contracts with medical groups to meet its need for physicians. Pursuant to such a contractual arrangement, Dr. Carrillo as an employee of Orthopedic Trauma, P.C., provided care to Plaintiff, as well as to members of the general public, at Shattuck. [ECF No. 180 ¶¶ 5-6].

         On March 29, 2012, Plaintiff saw Dr. Carrillo for the first time for a consultation. After X-rays revealed osteoarthritis in Plaintiff's left knee, Dr. Carrillo explained that a knee replacement would be the next step. [ECF No. 180 ¶¶ 8, 9]. She further explained to Plaintiff that the waiting period for the surgery would be six months to a year and gave Plaintiff a cortisone injection in his left knee in the meantime. [ECF No. 180 ¶ 10]. Shattuck planned to schedule Plaintiff's knee replacement as soon as it was approved by the Department of Correction. [ECF No. 180 ¶ 11].

         At MCI Shirley, the committee responsible for reviewing inmates' medical treatment options denied Plaintiff's request for a knee replacement ostensibly because Dr. Angeles failed to properly fill out the required paperwork. [ECF No. 181 ¶ 9]. Plaintiff learned that his request had been denied in the summer of 2012 due to the incomplete paperwork. He spoke with state officials who had the paperwork resubmitted and his knee replacement was then approved. [ECF No. 184 ¶¶ 22-25].

         On August 14, 2012 Shattuck scheduled Plaintiff for a total knee replacement. [ECF No. 184 ¶ 26]. He was admitted for the procedure on December 18, 2012, and Dr. DiCecca performed the knee replacement on December 19, 2012, with assistance from Dr. Carrillo, whose role was limited to holding a retractor. [ECF No. 180 ¶¶ 12-16]. During the procedure, a branch of Plaintiff's popliteal vein was cut. [ECF No. 180 ¶ 17]. Dr. DiCecca and Dr. Carrillo consulted with a general surgeon at Shattuck, who did not find evidence of acute bleeding or an interruption to the venous or arterial system but recommended that Plaintiff be placed on either Coumadin or subcutaneous Heparin following the procedure. [ECF No. 180 ¶¶ 18-20]. Checks of Plaintiff's International Normalized Ratio (“INR”) levels were ordered for the seven days following his knee replacement to ensure that the correct dose of Coumadin was being administered. [ECF No. 180 ¶ 21]. In violation of both Shattuck policy and the standard of care, Plaintiff's INR levels were not checked during the first four days following his surgery and Coumadin was administered in incorrect doses. [ECF No. 180 ¶¶ 22-23]. As a result, Plaintiff had internal bleeding which resulted in a hematoma in Plaintiff's left leg and pain that left him unable to sleep. [ECF No. 180 ¶¶ 19, 24, No. 181 ¶ 15]. Plaintiff remained hospitalized until January 8, 2013, when he was transferred back to an MCI facility. [ECF No. 180 ¶ 25].

         At some point after the December 18 surgery, Plaintiff developed laxity of his left knee, which necessitated revision surgery. [ECF No. 180 ¶ 28]. Dr. DiCecca performed the revision surgery on March 12, 2013 without assistance from Dr. Carrillo. [ECF No. 180 ¶¶ 29, 30]. Despite the revision surgery, Plaintiff continued to experience joint pain and instability in his left knee.

         He saw Dr. Carrillo again on April 11, 2013, [ECF No. 179-4 ¶ 42], and claims that during that visit Dr. Carrillo told him, “You're not getting a third surgery, your knee can just stay the way it is.” [ECF No. 181 ¶ 19]. At some point, Plaintiff threated Dr. Carrillo with a lawsuit.[3] [ECF No. 180 ¶¶ 31-32]. Dr. Carrillo's professional opinion was that Plaintiff was “never going to be happy with whatever we did, ” but she nevertheless referred him to Dr. DiCecca, who met with Plaintiff on May 22, 2013 and advised him to “live with the situation as it is.” [ECF No. 179-4 ¶¶ 42-43, No. 179-5 at 119:16-19].

         Plaintiff next consulted with a nurse practitioner at MCI Concord, who noted on July 17, 2013 that his “knee [was] still very unstable with severe laxity and crepitus.” [ECF No. 179-3 at 97-105]. On November 7, 2013 and January 22, 2014, Plaintiff met again with Dr. DiCecca, who noted that it was not entirely clear what was causing his continued pain but told him not to pursue additional treatment. [ECF No. 179-4 ¶¶ 45-46].

         On June 12, 2015, Plaintiff was again examined by staff at Shattuck who told him that he needed an additional knee surgery but that that would require approval from Dr. Carrillo. This surgery was never arranged. [ECF No. 181 ¶ 21]. Plaintiff claims that the Shattuck staff met with Dr. Carrillo after he left and then reversed their view that he needed an additional surgery. [ECF No. 181 ¶ 21]. In response, Plaintiff filed a formal grievance and a lawsuit. [ECF No. 179-2 at 2].

         On May 15, 2017 just days after his eventual release from custody, Plaintiff was treated at Tufts Medical Center, where the doctors determined that his left knee replacement had “failed.” [ECF No. 179-4 ¶ 49]. On June 1, 2017, Plaintiff was scheduled for total hip and knee replacement surgeries, which were justified based on “severe pain associated with [the] activities of daily living.” [ECF No. 179-4 ¶ 49].


         Summary judgment is appropriate “if the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law.” Fed.R.Civ.P. 56(a). The Court must consider the facts of record and draw “all reasonable inferences therefrom in the light most favorable to the nonmoving party.” Borges ex rel. S.M.B.W. v. Serrano-Isern, 605 F.3d 1, 4 (1st Cir. 2010) (citing Houlton Citizens' Coal. v. Town of Houlton, 175 F.3d 178, 183-84 (1st Cir.1999)). The Court will not, however, “draw unreasonable inferences or credit bald assertions, empty conclusions, rank conjecture, or vitriolic invective.” Pina v. Children's Place, 740 F.3d 785, 795 (1st Cir. 2014) (citation omitted). “An issue is ‘genuine' if the evidence of record permits a rational factfinder to resolve it in favor of either party, ” and a “fact is ‘material' if its existence or nonexistence has the potential to change the outcome of the suit.” Borges, 605 F.3d at 4-5. The substantive law determines which facts are material. A ...

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